Rural Appalachia is a medically underserved area whose residents experience significant healthcare disparities. Because of the insular nature of rural Appalachian communities, change from within is particularly important. Thus, attracting residents from these areas to the biomedical, behavioral, and clinical research workforce may be essential for reducing the critical health disparities in the region. However, the low income, high unemployment, and substandard health care that epitomize rural Appalachia evolve in part from a fundamentally devalued educational system. Studies show that students in these reduced-income rural schools have lower educational aspirations and are less likely to consider college as a viable option due to the contextual barriers they face, including limited economic resources, few role models with postsecondary education, a lack of active parental support, and a fear of 'fitting in' to the college lifestyle. However, studies also indicate that these same students possess a fiercely independent nature that would serve as a critical asset for achieving success in higher learning pursuits, and that strong cultural links would promote 'giving back' to their community's needs. Thus, rural Appalachian students possess the skills and capacities to succeed in a postsecondary educational environment if they could effectively confront and eliminate the perceived barriers preventing them from doing so. Our long range goal in this effort is to develop efficacious interventions that both reduce these contextual barriers (via mentoring and support) and increase interest in (via direct exposure to research and career options) pipeline science, technology, engineering, mathematics, and medical science (STEMM) majors among Appalachian youth. Our objective is to determine the extent to which such a multifaceted intervention strategy leads to increased intentions to pursue an undergraduate STEMM degree. Our hypothesis is that students who experience such interventions will show increases in important intrapersonal social-cognitive factors and in their intentions to pursue a postsecondary degree than students not exposed to such interventions. Our specific aims are to 1) understand the role of barriers to and support for higher education in Appalachian high school students' interest in pursuing STEMM-related undergraduate degrees, and 2) to develop sustainable interventions that decrease barriers to and increase support for higher education and that increase STEMM-related self- efficacy and interest. Achieving these aims will provide concrete tools for schools across rural Appalachia to use to increase the number of their students equipped with the skillsets required to join our State's high-growth biomedical and clinical research industry workforce.